This Mentored Patient-Oriented Research Career Development (K23) Award will enable the candidate, a community-based general academic pediatrician, to become an independent investigator in the field of mental health services research. The long-term career goal is to develop the skills necessary to conduct community-based clinical investigations of parent-provider communication that will improve emotional and behavioral outcomes for children of color. Keys to the career development are strong clinical experiences that inform the proposed research and an experienced team of advisors. The candidate will complete rigorous training with her primary mentor, Lawrence Wissow MD, MPH, a board-certified child psychiatrist and pediatrician with expertise in parent provider communication and mental health services research, Vonnie McLoyd, PhD, a developmental psychologist with extensive experience in the investigation of the impact of socioeconomic factors on outcomes for African American children and their families, Robert McCarter, ScD, a biostatistician with experience in training junior faculty members in advanced research methodologies, and Joseph Wright, MD, MPH, an established researcher with experience in community outreach and a national leader in child advocacy and translating research efforts into policy. Training goals for this award are to 1) develop theoretical and methodological expertise in the study of parent provider communication in the pediatric primary care setting; 2) gain a foundational understanding of the social perspectives that influence African American families in their interactions with the medical community; and 3) understand the biostatistical principles involved in conducting studies that will examine parent provider communication in communities of color. Research goals of this award are to complete a cross-sectional study of parent provider communication with African American parents of children ages 2-5 years from lower and middle/upper socioeconomic backgrounds. Investigations will also examine the effect of two potentially modifiable factors (maternal self efficacy in interactions with her child's provider and provider communication style) on the relationship between SES and maternal disclosure of psychosocial issues among African American mothers. With such training and research experience, the candidate will be prepared to develop culturally relevant, theoretically-based interventions for providers and parents that will reduce barriers to communication between African American parents and pediatric primary care providers and provide a first step in reducing disparities in mental health outcomes for African American children. [unreadable] [unreadable] [unreadable]